| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| RSC INSURANCE BROKERAGE INC3 Filed as: RSC INSURANCE BROKERAGE, INC. | 2270 DOUGLAS BOULEVARD, SUITE 220 ROSEVILLE, CA 95661 | KAISER FOUNDATION HEALTH PLAN, INC. | $38K | $0 | $38K | 5.63% |
| PETRA PACIFIC INSURANCE SERVICE, IN3 Filed as: PETRA PACIFIC INS. SERVICE, INC. | 13950 CERRITOS CORPORATE DRIVE SUITE A CERRITOS, CA 90703 | KAISER FOUNDATION HEALTH PLAN, INC. | -$3K | $0 | -$3K | -0.49% |
| RSC INSURANCE BROKERAGE INC3 Filed as: RSC INSURANCE BROKERAGE, INC. | PO BOX 818078 CLEVELAND, OH 44181 | UNITEDHEALTHCARE INSURANCE COMPANY | $15K | $0 | $15K | 4.94% |
| BEERE & PURVES INC3 Filed as: BEERE & PURVES, INC. | 500 YGNACIO VALLEY ROAD, SUITE 450 WALNUT CREEK, CA 94596 | UNITEDHEALTHCARE INSURANCE COMPANY | $0 | $6K | $6K | 1.98% |
| RSC INSURANCE BROKERAGE INC3 Filed as: RSC INSURANCE BROKERAGE, INC. | 140 2ND STREET, SUITE 318 PETALUMA, CA 94952 | DELTA DENTAL OF CALIFORNIA | $10K | $0 | $10K | 10.00% |
| RSC INSURANCE BROKERAGE INC3 Filed as: RSC INSURANCE BROKERAGE, INC. | 160 FEDERAL STREET, 4TH FLOOR BOSTON, MA 02110 | SUN LIFE ASSURANCE COMPANY OF CANADA | $8K | $0 | $8K | 15.94% |
| RSC INSURANCE BROKERAGE INC3 Filed as: RSC INSURANCE BROKERAGE, INC. | 160 FEDERAL STREET, 4TH FLOOR BOSTON, MA 02110 | VISION SERVICE PLAN | $2K | $0 | $2K | 10.00% |
No Schedule C service providers reported on this filing.
Benefits declared on the Form 5500 main form (✓ = also has a Schedule A insurance contract; otherwise the benefit is funded out of plan assets or via a Schedule C TPA).
The plan reports several different headcounts depending on which form you read. Each one measures a different slice of the population.
| Active participants | 284 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 284 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN, INC. | 127 | $981K |
| Dental | DELTA DENTAL OF CALIFORNIA | 210 | $95K |
| Vision | VISION SERVICE PLAN | 129 | $24K |
| Life insurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 296 | $51K |
| Short-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 296 | $51K |
| Prescription drug(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN, INC. | 127 | $981K |
| Other | SUN LIFE ASSURANCE COMPANY OF CANADA | 296 | $51K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 296 | — |
Why the numbers differ. Form 5500 line 6 counts employees + retirees + beneficiaries; no dependents. Schedule A persons-covered counts everyone enrolled, including spouses and children, so it usually exceeds line 6 by 30-60% on a working-age workforce. The medical row is normally the broadest single line because it has the highest take-up; dental/vision/life often dip below it. Stop-loss / reinsurance contracts sometimes report the carrier's full underwriting pool rather than this filer's headcount; the row is shown for transparency but shouldn't be read as "people in this plan."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.